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Organization

KATHRYN JOHNSON

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. KATHRYN JOHNSON LCSW (PSYCHOSOCIAL CLINICIAN II)
(352) 988-4181
Entity
Organization

Contact information

Practice address
4400 N HIGHWAY 19A, SUITE 4, MOUNT DORA, FL 32757-2032
(352) 988-4181
Mailing address
5655 S ORANGE AVE, ORLANDO, FL 32809-4289
(407) 895-4100
(407) 422-4492

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
SW 6550
SOCIAL WORK LICENSE
FL
Enumeration date
11/01/2006
Last updated
08/22/2020
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